NPIMap

Organization Active NPI

Children's Home Association of Illinois

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Peoria, IL
National Provider Identifier
1932633427
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CHILDREN'S HOME ASSOCIATION OF ILLINOIS
Practice address
404 NE Madison Ave
Peoria, IL 61603-3720
Phone
(309) 685-1047
Fax
(309) 687-7299
NPI assigned
Apr 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Julie Siebert
Title
Director of Compliance
Phone
(390) 685-1047

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X IL Primary

Addresses

Primary practice location

404 NE Madison Ave
Peoria, IL 61603-3720

Mailing address

2130 N Knoxville Ave
Peoria, IL 61603-2460
Phone (309) 685-1047

Other identifiers 1

IdentifierTypeStateIssuer
2B05-IPI-130MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Children's Home Association of Illinois20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1932633427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2130 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616032460",
            "telephone_number": "309-685-1047",
            "fax_number": "390-687-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 NE MADISON AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033720",
            "telephone_number": "309-685-1047",
            "fax_number": "309-687-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOME ASSOCIATION OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "SIEBERT",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "390-685-1047"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2B05-IPI-130",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.